Atopic dermatitis or eczema affects 2% of the population or about 2 million Americans with a chronic, often life-long, disfiguring disease which causes great physical and psychological anguish. Eczema patients have an intense itching hyper-reactive skin which may be comparable to the "irritable bronchi" in asthma. Both diseases appear to have impaired responsiveness to catecholamines, possibly due to a B-adrenergic blockade involving adnyl cyclase and cyclic 3'5' adenosine monophosphate. The high serum IgE in eczema, the similarity of its pathology to contact dermatitis, and the response of both disease to topical corti-costeroid therapy suggest a possible interaction between immediate and delayed hypersensitivity in eczema. Commitment of small T-lymphocytes to a massive cellular immune skin reaction could cause a relative cellular immune deficiency to other antigens. This could explain the extreme, often fatal, pox virus infections in patients with eczema. Dogs with dermatitis induced by grass pollen and by Demodex mites in mange may serve as animal models for eczema. The status of immediate and delayed hypersensitivity in patients with eczema will be evaluated with tests for skin reactions, IgE antibodies, leukocyte histamine release, lymphoblastogenesis, and migration inhibition factor (MIF) tests. Further, autonomic nervous status and cyclic AMP reactivity will be assessed. Possible blockade of catecholamine receptors in blood and skin cells by IgE will be examined with catecholamine-coated beads. If IgE reactivity is shown to alter cellular immunity, eczema may respond to immunologic and pharmacologic treatment. Further, a demonstration of a "gatekeeper" action of IgE for cellular immunity may afford an approach to control organ transplant rejection and cancer. BIBLIOGRAPHIC REFERENCES: Frick, O.L.: "Allergy" in Pediatrics, 16th Edition, Ed., A. Rudolph and H.L. Barnett, New York, Appleton-Century-Crofts, 1977. Frick, O.L.: "Allergic Rhinitis", Current Therapy, 1977, Philadelphia, Penn., W.B. Saunders Co., 1977.